Archive for the ‘cystitis’ Category

A Burn In the Urine-Managing Urinary Tract Infections (UTI)

June 15, 2012

One of the most common afflictions affecting most women and many men are urinary tract infections. UTIs are eight times more common in women than men. Initial symptoms typically include burning at the time of urination, frequent and intense urge to urinate, with discoloration of the urine ranging from cloudy to even bloody.

A bacteria, E. Coli, is responsible for 75% to 90% cases of acute uncomplicated cystitis. UTIs can also be caused by sexually transmitted disease (STD) such as Chlamydia and Mycoplasma. Other possibilities of painful urination include pelvic inflammatory disease, radiation cystitis, and hemorrhagic cystitis.

Bacteria causing urinary tract infections

E. Coli bacteria – common cause of urinary tract infections

Your doctor can make a presumptive UTI diagnosis in symptomatic women if there is either burning with urination and frequency without vaginal symptoms. The diagnosis can be confirmed with urinalysis showing positive nitrite or positive leukocyte esterase. The ultimate diagnosis is based on urine culture which grows out the bacteria and tells the doctor the best drug or antibiotic for treating the infection.

Uncomplicated cystitis does not cause fever. If a patient has a fever the UTI may have spread to the kidneys. A bacterial infection of the kidney is referred to as pyelonephritis and the symptoms often include pain in the back or side below the ribs, nausea and vomiting.

Urinary tract infections in men are often the result of an obstruction or blockage of the urinary tract — for example, a urinary stone or enlarged prostate — or from a catheter used during a medical procedure.

Optimal empiric therapy for nonpregnant women with uncomplicated UTI is with trimethoprim-sulfamethoxazole (TMP-SMZ, Bactrim, Septra) 160 mg/800 mg orally b.i.d. for three days. Other antibiotic options include ciprofloxacin (Cipro), levofloxacin Levaquin), or nitrofurantoin (Macrodantin).

Cranbeery juice and supplements are thought to be a good alternative preventive treatment for recurrent UTIs. Rich in vitamins C and E, antioxidants and anthocyanins, cranberry may help prevent E. coli from attaching to the bladder wall as well as bladder stone formation, and provide symptom relief for cystitis.

Bottom Line: UTIs are common in both men and women and can be easily diagnosed with a history, physical exam, and examinatioin of the urine. Treatment is effective with antibiotics. If it burns when you urine, call your doctor.

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Menopause and Bladder Control

May 4, 2010

Some women begin to have problems with their bladder and experience overactive bladder (gotta go, gotta go right now) and urinary incontinence or loss of urine at inopportune times at the time or shortly after menopause.

Does Menopause Affect Bladder Control?

Yes. Some women have bladder control problems after they stop having periods (menopause or change of life). If you are going through menopause, talk to your health care team.

After your periods end, your body stops making the female hormone estrogen. Estrogen may help keep the lining of the bladder and urethra healthy. A lack of estrogen could contribute to weakness of the bladder control muscles.

Pressure from coughing, sneezing or lifting can push urine through the weakened muscle. This kind of leakage is called stress incontinence.

Although there is no evidence that taking estrogen improves bladder control in women who have gone through menopause, small does may help thicken the bladder lining and decrease the incontinence.  Your doctor can suggest many other possible treatments to improve bladder control.

What Else Causes Bladder Control Problems in Older Women?

Sometimes bladder control problems are caused by other medical conditions. These problems include:

Infections

Nerve damage from diabetes or stroke

Heart problems

Medicines

Feeling depressed

Difficulty walking or moving

A very common kind of bladder control problem for older women is urge incontinence. This means the bladder muscles squeeze at the wrong time and cause leaks.

If you have this problem, your doctor can prescribe medication that can certainly alleviate that problem.

What Treatments Can Help You Regain Bladder Control?

Your doctor may recommend limiting foods or fluids, such as caffeine, which are bladder irritants and increase the desire to go the rest room.

There are also pelvic exercises that can strengthen the muscles in the urethra and the vagina.   Life’s events like childbirth and being overweight, can weaken the pelvic muscles.

Pelvic floor muscles are just like other muscles. Exercise can make them stronger. Women with bladder control problems can regain control through pelvic muscle exercises, also called Kegel exercises.

Exercising your pelvic floor muscles for just five minutes, three times a day can make a big difference to your bladder control. Exercise strengthens muscles that hold the bladder and many other organs in place.

Two pelvic muscles do most of the work. The biggest one stretches like a hammock. The other is shaped like a triangle. Both muscles prevent leaking of urine and stool.

Pelvic exercises begin with contracting the two major muscles that stretch across your pelvic floor. There are three methods to check for the correct muscles.

1.     Try to stop the flow of urine when you are sitting on the toilet. If you can do it, you are using the right muscles

2.     Imagine that you are trying to stop passing gas. Squeeze those same muscles you would use.

3.     Lie down and put your index finger inside your vagina. Squeeze as if you were trying to stop urine from coming out. If you feel tightness on your finger, you are squeezing the right pelvic muscle.

Do your pelvic exercises at least three times a day. You can exercise while lying on the floor, sitting at a desk or standing in the kitchen.

Be patient. Don’t give up. It’s just five minutes, three times a day. You may not feel your bladder control improve until after three to six weeks. Still, most women do notice an improvement after a few weeks.

Other treatments include inserting a device, a pessary, directly into the vagina to lift the urethra and the base of the bladder to its proper position behind the pubic bone.  And finally, if the conservative methods of medication, exercises, and dietary modification don’t work, then you should talk to your doctor about one of the surgical procedures that can lift the bladder into the proper position to prevent leakage

Bottom Line: No one needs to suffer the embarrassment of urinary incontinence.  Help is available for all those women who have bladder control problems

Urinary Tract Infections in Women-Taking the Burn Out of Urine

May 3, 2010

Urinary tract infections (UTI) are a serious health problem affecting 8.3 million Americans each year. 53% of all women have had at least one urinary tract infection during their lifetimes. Many women suffer from frequent UTIs. Nearly 20 percent of women who have one UTI will have another infection. This article will cover the causes, symptoms, and treatment of UTIs in women.

What are the causes of UTI?

Most infections arise from bacteria, Escherichia coli (E. coli), which normally lives in the colon. These bacteria gain access to the urinary tract through the urethra or the tube that carries urine from the bladder to the outside of the body.

An infection limited to the urethra is called urethritis. If bacteria move to

the bladder and multiply, a bladder infection, called cystitis, results. If the infection is not treated promptly, bacteria may then travel to the kidneys. A kidney infection is called pyelonephritis.

Microorganisms called Chlamydia and Mycoplasma may also cause UTIs in women, but these infections tend to remain limited to the urethra and reproductive system. Unlike E. coli, Chlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both partners.

Who is at risk?

In women the rate of UTIs gradually increases with age. Scientists are not sure why women have more urinary infections than men. One factor may be that a woman’s urethra is short, allowing bacteria quick access to the bladder. Also, a woman’s urethral opening is near sources of bacteria in the anus and the vagina. For many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are unclear.

Some women are more prone to getting a UTI than others. Women with diabetes have a higher risk of a UTI because of changes in the immune system. Any other disorder that suppresses the immune system raises the risk of a urinary infection.

According to several studies, women who use a diaphragm are more likely to develop a UTI than women who use other forms of birth control. Recently, researchers found that women whose partners use a condom with spermicidal foam also tend to have growth of E. coli bacteria in the vagina.

What are the symptoms of UTI?

The most common symptoms include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. It is not unusual to feel bad all over-tired, shaky, washed out-and to feel pain even when not urinating. Often women feel an uncomfortable pressure above the pubic bone. The urine itself may look milky or cloudy, even reddish if blood is present. Normally, a UTI does not cause fever if it is in the bladder or urethra. A fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.

How is UTI diagnosed?

To find out whether you have a UTI, your doctor will test a sample of urine for pus and bacteria. In the urinalysis test, the urine is examined for white and red blood cells and bacteria. Then the bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys the bacteria.

How is UTI treated?

UTIs are treated with antibiotic medications. The choice of drug and length of treatment depend on the patient’s history and the urine tests that identify the offending bacteria. The sensitivity test is especially useful in helping the doctor select the most effective drug. The drugs most often used to treat routine, uncomplicated UTIs are trimethoprim (Trimpex), trimethoprimlsulfamethoxazole (Bactrim, Septra, Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and ampicillin (Omnipen, Polycillin, Principen, Totacillin). A class of drugs called quinolones includes four drugs approved in recent years for treating UTI. These drugs include ofloxacin (Floxin), norfloxacin (Noroxin), ciprofloxacin (Cipro), and trovafloxin (Trovan).

Often, a UTI can be cured with I or 2 days of treatment if the infection is not complicated by an obstruction or other disorder. Many doctors ask their patients to take antibiotics for a week or two to ensure that the infection has been cured. Most doctors suggest that drinking plenty of water helps cleanse the urinary tract of bacteria. During treatment, it is best to avoid coffee, alcohol, and spicy foods.

Recurrent Infections in Women

Women who have had three UTIs are likely to continue having them. Four out of five such women get another within 18 months of the last UTI. Many women have them even more often. A woman who has frequent recurrences (three or more a year) can take low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for 6 months or longer. If taken at bedtime, the drug remains in the bladder longer and may be more effective.

Additional steps that a woman can take on her own to avoid an infection:

I. Drink plenty of water every day.

  1. Urinate when you feel the need; don’t resist the urge to urinate.
  2. Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra.
  3. Take showers instead of tub baths and avoid bubble baths.
  4. Cleanse the genital area before sexual intercourse.
  5. Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.
  6. Use cotton underwear as synthetics will trap bacteria.

Bottom line: UTIs are one of the most common infections occurring in women. The diagnosis is easily made and most women can be cured with a single course of antibiotics. Others need low-dose daily medication to control their infections.

Stop Those Urinary Tract Infections – Cranberry Juice to the Rescue

May 3, 2010

Recurrent urinary tract infections are common in many women and in some men. Their symptoms of frequency, burning on urination, and urgency of urination are bothersome and can impact the quality oflife of those who are affected. The treatment for an acute urinary tract infection (UTI) consists of drinking addition water and antibiotics. Also effective is the use of cranberry juice. This article will review the benefits of using cranberry juice to prevent UTIs.

Most urinary tract infections are caused by bacteria from the colon and rectal area. The most common of these bacteria, E. Coli. is responsible for over 90% of all UTI. He. Coli and other bacteria usually enter the urinary tract through the urethra, a tube that carries urine out of the body. Once inside the body, E. Coli uses special hairnlike structures called P.-fimbria to stick to the wall of the bladder. Once attached to the bladder wall, the bacteria can multiply, causing a UTI.

Risk factors for UTIs

Women are more prone to UTIs then men because the female urethra is shorter, and therefore provides less of a barrier to the entry of bacteria. Sexual activity it is a risk factor for UTIs because intercourse can increase the chance that bacteria trom the rectal and vaginal area will enter the urethra. Menopause is also a risk factor, since the reduced level of estrogen permits the overgrowth of bacteria in the area of the urinary opemng.

Cranberry juice to the rescue

Some individuals develop recurrent UTIs, sometimes several per year, and a growing body of evidence now confirnls that cranberry products can reduce the risk of future UTIs. No known treatment can prevent UTIs hundred percent of the time, but clinical trials show that it leads the majority of people benefit from taking cranberry products. These products, when taken in appropriate dosages, are safe and effective. So, although cranberries can treat a UTI you currently have, he can help reduce the risk of having a future infection.

Most urinary tract infections occur when bacteria enter through the urethra and then stick to the wall of the bladder. Recent research has revealed a cranberry contain a class of compounds called proanthocyanidins, which bind to the bacteria and prevent it from sticking to the bladder wall. This makes it easier for the bacteria to be tlushed out in the urine before a UTI can start.

Approximately 8-10 ounces of 27% cranberry juice cocktail has been shown to reduce UTI risk. This amount of juice contains an average of 30-35 mg proanthocyanidins. For those trying to manage their weight, the extra calories from drinking cranberry juice cocktail contains approximately 175 calories, which, if consumed daily, can result in significant weight gain if the excess calories aren’t burned through exercise or physical activity. A cranberry supplement can provide a low-calorie alternative to the high calorie liquid drink.

All cranberry products contain some proanthocyanidins, but the amount varies dramatically between products. Therefore it is important to choose a product that has been independently tested and certified for proanthocyanidin content. If the actual content of proanthocyanidins in a cranberry supplement has not been measured and independently certified, the efficacy of that product is uncertain. Most health food stores can provide this nutritional supplement.

Bottom line: Recurrent urinary tract infections are a common affliction and can easily be treated with antibiotics. IIowever. cranberry juice can be an effective prophylaxis against these uncomfortable and occasionally incapacitating infections.

Cystitis-How To Leave Home Without It

April 13, 2010

What does sex, bubble bath and thongs have in common?  Answer: They may all be causes of cystitis.  If you are a woman who has ever suffered from cystitis then you will know just how debilitating and miserable it can be, you you can perhaps take comfort from the fact that you are far from alone.  It seems that at last 20% of women have had an attack at some point in their lives, and 20% of those will get more than one episode a year.

There is certainly no mistaking the feeling it brings, which usually starts with a strong sensation of needing to urinate.  When you try to go, it either burns horribly, or nothing seems to come out.  You may have a full, uncomfortable sensation in the bladder, plus an aching back and stomach and a general feeling of being unwell.  The most common cause is an infection caused by bacteria.  It isn’t only a female problem but far more common in women than men.  The reason is that the internal plumbing of women is much shorter than in a man and the relationship of the rectum which is usually the source of the bacteria is closer to the urinary tract in women than in men.

A bacteria, called E. Coli, is usually the culprit.  Since E. Coli coming from the rectum can reside in the vagina and then can have easy access to the urethra or the tube that transmits urine from the bladder to the outside of the body.  This is why it is beneficial for women to wipe from front to back when they use the restroom.  If you swipe the wrong way, you can move the bugs from the rectum into the vagina and then into the urethra.  Another recommendation is to switch from nylon or synthetic underwear to the cooler cotton briefs which discourage the growth of bacteria.  Also, thongs and G strings may be very sexy but they are bad news for cystitis sufferers as the string is an effective way for bacteria to hitch a ride from your bottom to your bladder.

Another suggestion is to change the bacterial flora of the gastrointestinal tract.  This can be accomplished by regularly eating yoghurt which contains the good bacteria lactobacillus or acidophilus.

It is also crucial to drink large quantities of water to flush away any bacteria.  Also, it is recommended that sufferers of frequent cystitis go the toilet when you first feel the urge.  The longer you hold in urine, the fuller your bladder is, with more potential for bacteria to grow and proliferate.  Using bubble baths or irritating soaps around the vagina should also be avoided as these agents can upset the delicate balance of acidity and alkalinity in your skin so that bacteria can flourish.

It also appears that sexual intercourse, promotes moving bacteria from the vagina into the urethra.  This then starts the process of bacterial multiplication in the bladder and creates the symptoms of cystitis.  Therefore, it is important for women who get cystitis after intercourse to urinate frequently after sexual intimacy to wash the bacteria out of the urethra so they don’t become permanent residents and create an infection.

For years doctors have recommended cranberries of a method to reduce the attacks of recurrent cystitis.  Initially, it was thought that the cranberries were a source of acid and this prevented cystitis.  Now research has shown that the cranberries contain chemicals that help stop the bacteria from sticking onto the bladder wall.  Because cranberry juice can be quite high in sugar, you might prefer to take one of the cranberry supplements that are available.

Beating back an attack

The first practical step is to consume 2 glasses of water every 20 minutes for the first three hours.  This will help you ladder to flush itself out, and sometimes is enough on it s own to prevent further problems.  If not, gulp down a few glasses of cranberry juice.  Sipping a glass of water with a teaspoon of bicarbonate of soda stirred into it may help the burning sensation when you urinate.

If these simple measures don’t relieve your symptoms in a day or two, you may need to see your doctor and take a short course of antibiotics.  Failure to treat the infection can result in a much more serious kidney infection.  Also, if you have more than 3-4 infections in a 12 month period you will want to see your doctor to be sure there isn’t something else more ominous causing these infections.